Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Queens Medical Centre on 18 August 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice.
• Feedback from patients about their care was consistently and strongly positive.

• The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• Information about how to complain was available and easy to understand.
• The practice had a clear vision which had quality and safety as its top priority in delivering person centred care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We carried out this announced inspection to follow up concerns identified in December 2013. Our concerns related to the management of medicines, which was not robust and safe; recruitment practices not being sufficiently robust to protect patients from being cared for by unsuitable staff; and assessment and monitoring of potential risks was not managed effectively enough to promote patient safety.

We gave short notice of this inspection because we needed to meet the practice manager, as the registered manager had retired. Following the last inspection, we had received an action plan from the provider, which showed how they intended to become compliant with the Health and Social Care Act 2008.

At this inspection, we wanted to see if patients received a safe, effective and well led service in relation to specific areas to be followed up. We did not speak to patients using the service because the areas we needed to follow up related to management systems with the purpose of reducing potential risks to patients. We saw improvement in some aspects of quality monitoring systems and working practices. For example, the practice had implemented robust recruitment and safe management of medicines systems so was compliant. However, other audits were not effective in providing assurance of appropriate arrangements for safeguarding adults or reduction in potential risks. Some clinical emergency equipment was out of date. This demonstrated audits implemented since our last inspection were not yet robust in providing assurance of patient safety. We considered these risks to be minimal and rectifiable. We have taken the proportionate step of repeating one compliance action to enable the provider to become fully compliant with the associated regulations. We have also made another compliance action with regard to safeguarding adults.

We visited the surgery over the period of two days and met and spoke with nine people who were using the surgery. We spoke with GPs, the registered manager, a nurse and healthcare assistant who were on duty. We obtained information and support from the administration staff which included the practice manager, administration manager and other administration staff. We contacted members of the patient participation group before and after the inspection visits for their feedback. We were told the surgery had a new practice manager who had been in post six months. The registered manager told us they had already identified some areas they needed to develop within the service to improve that had arisen during this period.

People told us they received the treatment, care and support they needed. We were told, “Lovely GP.” “Very happy with GP.” One person told us they routinely saw their own GP but when they were not able to they were, “pleasantly surprised that the new GP knew what was needed.” Although this was not the experience of some of the people we spoke with.

We identified there were areas of improvement required. Appropriate checks were not carried out on staff to make sure they were appropriate to be working with vulnerable adults or children. The practice for the management of medicines was not robust and safe. There were gaps in how the provider monitored the quality of the services it provided.